MANUAL OVERVIEW The Division of Alcoholism and Drug Abuse, directed by Marc Galanter, M.D., was established within the Department of Psychiatry, reflecting a collaborative effort on the part of NYU School of Medicine and Bellevue Hospital Center to integrate and expand services for addicted patients at the medical center. By unifying existing teaching and research facilities and designating new ones, the NYU/Bellevue affiliation represents a major initiative for the School of Medicine in research, teaching, and patient care.
CONTENTS
The purpose of this manual is to describe the Postgraduate Medical Training in the Substance Abuse Treatment System at New York University Medical School/Bellevue Hospital Center and to present the format, structure, and didactic content of this training in such a way that it can serve as a resource and replicable model in other institutions. Adapted to appropriate training sessions, it may be used to learn how to systematically deliver Postgraduate Medical Training in the Substance Abuse Treatment System of a Teaching Hospital.
This curriculum is divided into an Introduction and four Content Sections:
Introduction and Description of the Training
I. Guidelines for Postgraduate Medical Training Programs
II. Relevant Basic Science Training
III. Supervised Clinical Experience
IV. Research
V. Teaching
TRAINING CONSIDERATIONS Audience: The recommended number of participants can range from four to twelve and will have completed an accredited residency in a medical specialty.
Logistics and Timeframe: This training is presented twice weekly: i.e., one day didactic presentation and one day experiential, clinical work.
Equipment: Newsprint charts or overhead projections, prepared in advance, may be used. Arrangements must be made in advance to reserve the necessary equipment to provide training.
Facilities and Resources: To be eligible for accreditation, the subspecialty program must function as an integral part of a residency program in a specialty providing direct patient care that is accredited by the Accreditation Council for Graduate Medical
Education(ACGME). Its services should primarily be based in the teaching facility where the parent accredited residency is located. The parent institution must be qualified to provide the caliber of training necessary for a certificate of special qualification or a certificate of added qualification approved by the American Board of Medical Specialties (ABMS).
All aspects of the program must be clearly lodged in designated facilities, based on written agreements between the participating parties. There must be ample space and equipment for lectures and other training exercises. The facilities should assure appropriate accessibility to trainees and faculty, and quantity and quality care.
Training will require access to inpatient, partial hospitalization, residential, and ambulatory care treatment programs that provide an adequate number of patients and a variety of patient populations and addiction problems. Most currently accepted treatments must be represented, such as alcoholism rehabilitation, inpatient detoxification, methadone maintenance, narcotic antagonist maintenance, drug-free programs. The training program should strive for integration among clinical programs with which it is involved, providing comparability in evaluation (including physical and laboratory testing), referral, and follow-up. The record system must be designed for the retrievability of data pertinent to patient care, the monitoring of fellows' experiences, and the conduct of research.
The sponsoring institution must provide trainees with ready access to a medical school library. They should be assured easy access to a substantial number of texts and journals relevant to ADA. In addition, the program must promote an atmosphere of scholarly inquiry including the access to ongoing research activity in addiction medicine.
Training will be conducted by faculty and directors of the teaching units collaborating in this training. Faculty resources required for a program should be adequate for the number of trainees the program teaches; generally, there should be no less than one full-time faculty member per 1.5 trainees. The Program Director must have a minimum of two years full-time professional activity in the field of ADA, and be Board Certified in a medical specialty. The Program Director should also be a medical school faculty member with major commitment in an academic department at his or her respective school, preferably with a full-time appointment. He or she should devote at least half time to the ADA program. Depth in research resources and faculty is essential for a good program.
